Job Hunt - Help Needed! (aka I need to eat and I'm tired of selling my soul to CMGs)

[MechEDoc]

Looking for suggestions and contacts on a job hunt. I've been working several years for a large CMG in a mix of practice environments (high acuity & low SES urban ED, a desert town by a large reservation, and mixed PWN rural and urban patients).

In the next 6 to 12 months I am looking for a change, preferably to a SDG. I'm hoping to find a group that is truly democratic, open books for partners, and that has a high quality relationship with the hospital. Understandably, I would like to avoid groups that have a predatory approach to washing out non-partner members or have a select inner group of "more equal" partners that have financial interests in a billing, coding, or a management company that skims off profits for the inner clique.

I would be grateful for any information or contacts in the following areas: Spokane/Coeur d'Alene, Bozeman, Boise, Anchorage, Flagstaff, and Bend OR - or any other places of a similar ilk...

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[bikERdoc]

Sounds lovely. Unfortunately unicorns are a dying breed.

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[MechEDoc]

Sadly Vancouver isn't much better than the places I've been working at. Dead lumber and port industries, meth, single contract group with some possible challenges... They seem like a high risk group for an outside takeover.

 

[EctopicFetus]

PM me.. i know people in flagstaff. I know people on those other cities too but I know they aren’t hiring.

 

[slurpy15]

Spokane...ugh? Why? One of these is not like the others...

 

[slurpy15]

I live in the mountain west, and here is what I know. Spokane is a hole. Bozeman is NEVER hiring and they receive at least 15 resumes a month. Boise is also never hiring, although word is they might need a Peds person. Flagstaff used to have awaiting list, and there's plenty of meth, although it's a nice group. Bend is often hiring, but they work their docs hard, although they get paid for it. Anchorage does not pay; beyond that I don't know.

You are picking VERY competitive geographic areas without many jobs.

 

[The White Coat Investor]

I live in the mountain west, and here is what I know. Spokane is a hole. Bozeman is NEVER hiring and they receive at least 15 resumes a month. Boise is also never hiring, although word is they might need a Peds person. Flagstaff used to have awaiting list, and there's plenty of meth, although it's a nice group. Bend is often hiring, but they work their docs hard, although they get paid for it. Anchorage does not pay; beyond that I don't know.

You are picking VERY competitive geographic areas without many jobs.

Agreed these are competitive areas. Surprised nothing in Utah or Colorado made your list. If you're trying to avoid larger cities there are places like Fort Collins, Ogden, Logan, Telluride, St. George etc.

Boise, Flagstaff and Anchorage were hiring the year I came out of the military. Your best bet in Anchorage may be the Native Hospital, which is not an SDG. I didn't look in Spokane or Bozeman. Portland may be more competitive than any of these, but I don't know anything about the group in Bend.

As a general rule, partner physicians in Alaska do very well. The employee docs probably do also.

 

[slurpy15]

Maybe the OP hates smog, hence no Utah.

Agreed these jobs are insanely competitive. Portland has two jobs that are always open, so they must be insane (Adventist, staffed by CEP, which is more of a ponzi scheme than an SDG) and Kaiser, which speaks for itself. Its famous pension is notoriously underfunded, so caveat emptor. The Bend group is good, but they work crazy hard. I believe they are part of a larger group that staffs several EDs in the area. I've heard good things.

It's not SDG, but I've heard good things about the Rogue Valley Group in Oregon if that would fit your bill.

You have, as my OG WCI has mentioned, picked the most competitive markets in the country. They will be interviewing you, not vice versa.

 

[namethatsmell]

...Kaiser, which speaks for itself. Its famous pension is notoriously underfunded, so caveat emptor.

Care to expound and maybe cite any sources you have to substantiate this claim?


I’m with you 100% on saving early to get to FIRE .



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[slurpy15]

Sure.

HERE IS THE LINK: Longer lives, falling rates put pressure on hospital pension plans

 

[namethatsmell]

Sure.

HERE IS THE LINK: Longer lives, falling rates put pressure on hospital pension plans

Fair enough, thanks. I was considering a Kaiser job a few years ago and they gave the impression they had the cash on hand to fully fund their pensions.


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[slurpy15]

Caveat emptor. Exactly.

I think it's interesting that Kaiser has upped their game. New grads and docs just can't wait for a nonexistent pension while being underpaid with their massive loans in an unstable health care system. There is no way their pension fund can be solvent. If you sell fairly reasonable insurance but pay your nurses 100k a year starting salary with a generous pension, it's fairly clear you won't be able to fund said pension no matter how "efficient" your protocols. Nursing salaries are one of the biggest expenses in medicine and are surely costing Kaiser more than they can afford.

 

[GeneralVeers]

Caveat emptor. Exactly.

I think it's interesting that Kaiser has upped their game. New grads and docs just can't wait for a nonexistent pension while being underpaid with their massive loans in an unstable health care system. There is no way their pension fund can be solvent. If you sell fairly reasonable insurance but pay your nurses 100k a year starting salary with a generous pension, it's fairly clear you won't be able to fund said pension no matter how "efficient" your protocols. Nursing salaries are one of the biggest expenses in medicine and are surely costing Kaiser more than they can afford.

Exactly. It's always better to get the money up front, and you can use it as you wish. I wouldn't bet my future or retirement on promises made by a private entity, the government or anyone else.

 

[slurpy15]

Agreed. Many pensions depend on a high interest rate environment to stay solvent, which is not the case nowadays. I wish people would realize pensions are gone and that they don't work with today's employment environment. Then we could move on to educating people on finance and 401ks.

 

[MechEDoc]

Bend is often hiring, but they work their docs hard, although they get paid for it.

what do you know about Bend? I love to learn more. I've only heard secondhand mixed things about the group in Bend. I lived in Bend for about 6 months, loved many things about the city but other things not so much. St. Charles Hospital is in significant distress and there may be machinations that they may be trying to end the contract with their private groups and replace it with a cheaper alternative.

You are picking VERY competitive geographic areas without many jobs.

I know - ugh!

 

[MechEDoc]

I live in the mountain west, and here is what I know. Spokane is a hole. Bozeman is NEVER hiring and they receive at least 15 resumes a month. Boise is also never hiring, although word is they might need a Peds person. Flagstaff used to have awaiting list, and there's plenty of meth, although it's a nice group. Bend is often hiring, but they work their docs hard, although they get paid for it. Anchorage does not pay; beyond that I don't know.

You are picking VERY competitive geographic areas without many jobs.

I can only imagine that Bozeman is extremely hard to get a job in.

I'm not wild about Spokane (Spokompton), but I could commute there from Coeur d'Alene.

I am open for ideas in Colorado. I looked around areas in the front range but the groups were either University (I'm not cut out for an academic career) or in groups that require extensive buy-in times (3 years or greater) with terrible pay throughout the buy in period.

Boise is a wonderful place and I am strongly considering it. I have a number of friends (MDs, PAs, and NPs) that have gone to work for EMI. There are two other groups that I'm not so keen on.

 

[slurpy15]

Colorado Springs is often hiring, but you are correct that they just extended their partnership track to several years, although for now you are well paid after the first few hundred hours. But it's Colorado Springs. There is Kaiser in Colorado, which may or may not be your cup of tea.

I've heard good things about the Boise groups; sorry to hear things have changed.

I don't know what your financial situation is, but have you considered moving to one of your dream destinations and then doing locums/working your way into the local group? You might make more money hourly and be able to have a great lifestyle. I know folks who are VERY happy doing that. Remember that SDGs can have a long buy in, as you noted, and that there's no guarantee or partnership.

 

[MechEDoc]

One of the Boise groups was bought / taken over by CEP which is now Vituity. They lost a contract site or relinquished - depending on who you talk to - to TeamHealth and were reportedly overstaffed with local clinicians. As such, a number of their physicians are reported to be traveling as firefighters for Vituity.

 

[slurpy15]

Oh...yuck. That sounds terrible. Any interest in locums? When I worked for the IHS (you can def. earn more elsewhere, but it was a fun and unique experience that accepts any state license) there were lots of folks from Colorado (it does pay better than pre-partner in Denver).

I assume that the CEP to Vituity switch (of which I was unaware) has dispensed with even the pretense of a democratic group?

 

[MechEDoc]

I'm sure they they are "democratic". Along with the Democratic People's Republic of Korea, Democratic Republic of the Congo, and the Lao People's Democratic Republic...

 

[MechEDoc]

Quick question re private groups. I'm on the trail of finding a job and finding that some groups are really coy when it comes to discussing rough compensation ballparks. Is this the norm? I don't even have a sense within $50k of what the compensation will be. It's along the lines of "you'll be fine". Umm, I have goals (house, retirement, etc.) and would like just a little bit of a sense of what "fine" means. Is this normative or aberrant behavior?

 

[GeneralVeers]

Quick question re private groups. I'm on the trail of finding a job and finding that some groups are really coy when it comes to discussing rough compensation ballparks. Is this the norm? I don't even have a sense within $50k of what the compensation will be. It's along the lines of "you'll be fine". Umm, I have goals (house, retirement, etc.) and would like just a little bit of a sense of what "fine" means. Is this normative or aberrant behavior?

If they won't tell you salary, then something shady is going on. The question to ask: "What was the MEDIAN salary last month?" They should be able to tell you the gross pay for the doctor in the middle of the pack in the last month or so. If they can't/won't provide that information then I would look elsehwhere.

 

[slurpy15]

Quick question re private groups. I'm on the trail of finding a job and finding that some groups are really coy when it comes to discussing rough compensation ballparks. Is this the norm? I don't even have a sense within $50k of what the compensation will be. It's along the lines of "you'll be fine". Umm, I have goals (house, retirement, etc.) and would like just a little bit of a sense of what "fine" means. Is this normative or aberrant behavior?

Many groups, for whatever reason, won't tell you up front. I think this is stupid. But they absolutely need to tell you before you sign. I agree that not telling you up front wastes everyone's time, but some groups are like that, for no good reason. Are you saying they expect you to sign with no compensation discussion?!

 

[KGflyboy]

Quick question re private groups. I'm on the trail of finding a job and finding that some groups are really coy when it comes to discussing rough compensation ballparks. Is this the norm? I don't even have a sense within $50k of what the compensation will be. It's along the lines of "you'll be fine". Umm, I have goals (house, retirement, etc.) and would like just a little bit of a sense of what "fine" means. Is this normative or aberrant behavior?

My experience has been different. It could be regional. I live in an area where the job market strongly favers the applicant. Many groups were happy to discuss ballpark numbers before I ever applied. They seem to be actively seeking out people and trying to convince them to apply.

Couple questions. Are you applying in places where the job market is less favorable? And are you speaking with people face to face, on the phone, or with email? I've had good luck getting numbers with informal phone calls with a group's recruiter or medical director prior to interviews. I doubt emails would be as effective.

I would think a group would want you to know the pay prior to interviewing. If they spend time and money recruiting and interviewing someone who won't work for the money they are offering, it wastes everyone's time. It is in everyone's interest to establish this early on so interviews are focused on people who have a reasonable chance of accepting the job.

 

[Hercules]

Quick question re private groups. I'm on the trail of finding a job and finding that some groups are really coy when it comes to discussing rough compensation ballparks. Is this the norm? I don't even have a sense within $50k of what the compensation will be. It's along the lines of "you'll be fine". Umm, I have goals (house, retirement, etc.) and would like just a little bit of a sense of what "fine" means. Is this normative or aberrant behavior?

Yeah that’s sketchy. When we do interviews we all go out for dinner with the group the night before then hit lunch the next day to catch any docs they haven’t met yet. After lunch they do the ED tour, say hey to the hospital’s CEO, and have a one-on-one meeting with me where they can ask any questions. During that time I show them a copy of our schedules with shift breakdowns for each doc and I show them our payroll spreadsheet for the last two months. I don’t let them take the spreadsheet with them because I don’t want it slipping into the wrong hands, but they fully get to see what their paycheck will look like and what they’ll be getting into. It would be a red flag for me if a group wasn’t willing to show you these kind of things.


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[slurpy15]

Yeah that’s sketchy. When we do interviews we all go out for dinner with the group the night before then hit lunch the next day to catch any docs they haven’t met yet. After lunch they do the ED tour, say hey to the hospital’s CEO, and have a one-on-one meeting with me where they can ask any questions. During that time I show them a copy of our schedules with shift breakdowns for each doc and I show them our payroll spreadsheet for the last two months. I don’t let them take the spreadsheet with them because I don’t want it slipping into the wrong hands, but they fully get to see what their paycheck will look like and what they’ll be getting into. It would be a red flag for me if a group wasn’t willing to show you these kind of things.


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Hercules has a great job, I think. Mobile is sounding better and better.

 

[Mbekweni]

Quick question re private groups. I'm on the trail of finding a job and finding that some groups are really coy when it comes to discussing rough compensation ballparks. Is this the norm? I don't even have a sense within $50k of what the compensation will be. It's along the lines of "you'll be fine". Umm, I have goals (house, retirement, etc.) and would like just a little bit of a sense of what "fine" means. Is this normative or aberrant behavior?

I found groups willing to talk hourly/salary for starting pretty easily. They got really coy when it came to full partner salary in some of the private groups. I have heard rumors that it's pretty outrageous. Ie they were offering $200/hr to start, a bit more for overnights but at full partner were making far more likely while taking a cut of the new hire's work.